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General NPI Number Information
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NPI Number | 1235593351
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Entity Type | Individual
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Provider Name | EUGENIO AQUINO
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Gender | Male
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 814 S HARVARD BLVD APT 12
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City | LOS ANGELES
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State | CA
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Zip | 90005
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Country | US
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Telephone | 323-239-2993
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Fax |
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Provider Business Mailing Address
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Address Line | 814 S HARVARD BLVD APT 12
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City | LOS ANGELES
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State | CA
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Zip | 90005-2553
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Country | US
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Telephone | 323-239-2993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 1223P0700X
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License Number State | TX
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